Active NPI
Fredda Wasserman, MFT
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1013926252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 37428
- Practice address
- 1950 Sawtelle Blvd Ste 355
Los Angeles, CA 90025-7072 - Phone
- (310) 503-1632
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 37428 | CA | Primary |
Addresses
Primary practice location
1950 Sawtelle Blvd Ste 355
Los Angeles, CA 90025-7072
Mailing address
9625 Bolton Rd
Los Angeles, CA 90034-1041
Phone (310) 503-1632
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EIN 41-2084865 | Other | CA | EMPLOYER TAX ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 37428 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1013926252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9625 BOLTON RD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900341041",
"telephone_number": "310-503-1632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 SAWTELLE BLVD STE 355",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900257072",
"telephone_number": "310-503-1632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "FREDDA",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 37428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER TAX ID #",
"identifier": "EIN 41-2084865",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.